MEDICARE: ALEJANDRO D CHEDIAK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	ME51163	FL
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	ME51163	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669401774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRO D CHEDIAK M.D.

Provider Business Mailing Address
First Line	:	7029 SW 61ST AVE
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-3420
Country	:	US
Telephone Number	:	305-666-2224
Fax Number	:	305-666-2297

Provider Business Practice Location Address
First Line	:	7029 SW 61ST AVE
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-3420
Country	:	US
Telephone Number	:	305-666-2224
Fax Number	:	305-666-2297

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	01/09/2013

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